The animal models using live pigs in the application and development of endoscopic submucosal dissection training 
	    		
		   		
		   			
		   		
	    	
    	 
    	10.3760/cma.j.issn.1671-0274.2019.07.019
   		
        
        	
        		- VernacularTitle: 活体猪模型在内镜黏膜下剥离术培训及推广中的应用 
 
        	
        	
        	
        		- Author:
	        		
		        		
		        		
			        		Jian LI
			        		
			        		
			        		
			        			1
			        			
			        		
			        		
			        		
			        		
			        		;
		        		
		        		
		        		
			        		Yunshi ZHONG
			        		
			        		;
		        		
		        		
		        		
			        		Pinghong ZHOU
			        		
			        		;
		        		
		        		
		        		
			        		Tao CHEN
			        		
			        		;
		        		
		        		
		        		
			        		Liqing YAO
			        		
			        		
		        		
		        		
		        		
		        		
		        			
			        		
			        		Author Information
			        		
		        		
		        		
			        		
			        		
			        			1. Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai Engineering and Research Center of Diagnostic and Therapeutic Endoscopy, Shanghai 200032, China
			        		
		        		
	        		
        		 
        	
        	
        	
        		- Publication Type:Journal Article
 
        	
        	
        		- Keywords:
        			
	        			
	        				
	        				
			        		
				        		Endoscopic submucosal dissection;
			        		
			        		
			        		
				        		Training;
			        		
			        		
			        		
				        		Animal models, live pigs
			        		
			        		
	        			
        			
        		
 
        	
            
            
            	- From:
	            		
	            			Chinese Journal of Gastrointestinal Surgery
	            		
	            		 2019;22(7):697-700
	            	
            	
 
            
            
            	- CountryChina
 
            
            
            	- Language:Chinese
 
            
            
            	- 
		        	Abstract:
			       	
			       		
				        
				        	 Endoscopic submucosal dissection (ESD) is the gold standard technique for performing en bloc resection of large superficial tumors in the upper and lower gastrointestinal tract. It has not started in China until early 2006, when it was introduced at Endoscopy Center of Zhongshan Hospital. However, ESD is technically more difficult and can result in more complications, limiting its development in China. At present, reports about ESD training system in China are still not available. Therefore, our center continuously explored and gradually established structured training courses relied on the live pig model. Between 2009 and 2013, we held 23 hands-on ESD training workshops with 550 endoscopists. Questionnaires were distributed via e-mail, and there were 460 participants performing ESD in a step-up approach on the live pigs. More than one half of trainees could perform ESD with en bloc resection in the imaginary "lesion" of colon and stomach, and there were higher rates of hemorrhage and perforation occurring in colorectal ESD as compared to gastric ESD. After graduating from our hands-on workshop, up to over 90% of participants started ESD practice in their home hospitals. It was mostly provided by high-grade hospitals (IIIA) which played a major role as tertiary referral centers, covering almost all provinces and major cities in China. The training on live pig model revealed to be safe and effective as a prior step to its application in humans. It may enable novice endoscopists to acquire ESD skills and start performing ESD as soon as possible. The role of adequate training is of course to influence the spread of this technique and promote ESD development around China.